Alcohol is now growing as a prime-time killer

Alcohol is growing as a prime-time killer

USN - A. Garcia says he knew he’d gotten lazy in recent years. He started working from home, began drinking a six-pack of IPAs after work “pretty much daily” and embraced “a very couch potato-esque life.”

“I definitely drank a lot more than the normal person, but in my mind, I was nowhere near hitting a danger zone because I wasn’t drinking to excess – I was more drinking just habitually, casually,” recalls Garcia, whom U.S. News is not fully identifying to protect his privacy. “I was never ... doing anything wild – it was so boring.”

Boring, that is, until Garcia tried to stop drinking in July. Two days later, he was experiencing slight hallucinations – a symptom of alcohol withdrawal – and ultimately headed to the emergency room for help. It was there that the 37-yearold was diagnosed with cirrhosis, a late stage of liver scarring often tied to chronic alcohol use, and put on the U.S. liver transplant waiting list for an immediate operation.

“Luckily I stabilized fairly quickly ... so that option was kind of taken off the table, but still when I left, I was still considered extremely highrisk,” Garcia says.

Though his age and his habits may not fit the normal perception of a person suffering the potentially fatal effects of alcohol misuse, national data shows Garcia is not alone, with booze cutting short the lives of those even younger than him at an increasing rate. And while it’s not always clear whether the surge is tied to better measurements or to alcohol consumption itself, experts are concerned. Between 1999 and 2017, for example, while adults ages 45 to 74 continued to have the highest alcohol-related death rates, those 25 to 34 saw the largest increases over time, according to a study published this year by researchers with the National Institute on Alcohol Abuse and Alcoholism. Nearly half of alcohol-related deaths in 2017 were the result of liver disease or overdoses, either from alcohol itself or combined with other drugs.

A separate study found that people between the ages of 25 and 34 saw the highest average annual increase – 10.5 percent – in cirrhosis-related deaths of any age group from 2009 to 2016, driven heavily by alcohol use, and the number of deaths from cirrhosis in this age group doubled. The findings stand “in contrast to any other time in recorded history,

(continued on page 17) so going back through the 70s,” says Dr. Elliot Tapper, lead author of the study and an assistant professor and liver specialist with the University of Michigan and Michigan Medicine. “The immediate reaction that everyone had across the country was, ‘This is what we see,’” Tapper says. “If you round in an American hospital, then you will find not only is alcohol-related disease markedly overrepresented – the chances that you find someone with an alcohol use disorder are very high simply in the population that’s hospitalized – but then two ... the list of patients on which a liver specialist rounds is almost uniformly, at this point, alcohol-related disease and disproportionately young people.” That dynamic is also playing out in the operating room. In a study

3.12, 6 p.m.

Virginia Credit Union will offer a free seminar with practical steps for identifying and prioritizing debt, reducing expenses, and accelerating the repayment of debt. The “Strategies for Eliminating Debt” seminar will be at Virginia Credit Union in the Boulders Office Park, 7500 Boulder View Drive.

To register, call 804-323-6800 or visit www.vacu.org/seminars 3.11, 6 p.m.

Henrico CASA will hold information sessions at 6 p.m. Wednesday, March 11 and at noon Thursday, March 19 for people who may be interested in volunteering to work in the court system on behalf of abused or neglected children.

The information sessions will be held in the CASA offices in suite A of the Hungary Spring Office Park, 3001 Hungary Spring Rd. To reserve a seat, contact Rebecca Kalman-Winston at 804-501-1670.

3.14-15, 10 a.m.- 4 p.m. Locals and tourists alike are invited to enjoy unique history, fascinating stories and a journey into the past during the biannual Time Travelers weekend.

Explore new participating sites and old favorites this year as 24 historic homes, churches, museums and more open their doors to visitors across the Richmond Region.

Each site will offer free admission to those visitors presenting a Time Travelers Passport available via download on participating locations’ websites. Additionally, several participating sites have developed new programming in observance of Women’s History Month. Download the passport, explore local history and get to know the Richmond Region, free of charge.

Visit thevalentine.org for info.

Submit your calendar events by email to: editor @legacynewspaper.com. Include the who, what, where, when & contact information that can be printed. Deadline is Friday.

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Henrico County Public Schools will propose starting the 2021-22 school year before Labor Day, and will hold a series of five community meetings on the idea. Families and members of the public are invited to ask questions, offer feedback and learn why the school division is moving toward this idea.

The sessions will include a short presentation from Henrico Schools leaders and staff members about the calendar process and some of the implications of an earlier start. That will be followed by opportunities to ask questions and comment. The five information sessions will be held at schools and libraries across Henrico County, and will include both morning and evening sessions, and include: • March 16- 10:30 a.m. - Tuckahoe Area Library, 1901 Starling Dr. 6:30 p.m. at Hermitage High School, 8301 Hungary Spring Rd. • March 19 - 6:30 p.m. at Henrico High School, 302 Azalea Ave. • March 24 6:30 p.m. at Pocahontas Middle School, 12000 Three Chopt Rd. • April 2 - 10:30 a.m. at Fairfield Area Library, 1401 N. Laburnum Ave. The school division will be posting detailed calendar information to henricoschools.us, along with a feedback portal, before the series of community meetings begins.

The School Board is tentatively scheduled to vote on the matter at its April 23 meeting, in order to give the Henrico community notice of the change more than a year in advance.

published last year, Dr. Brian Lee – a transplant hepatology fellow at the University of California–San Francisco – and colleagues found an increase in the proportion of liver transplants associated with alcohol-related liver disease, or ALD, between 2002 and 2016. In an email to U.S. News, Lee also says “the average age of transplant recipients for ALD has significantly declined over time, which is the opposite of the trend among other liver diseases.”

“It’s jarring to see somebody in their 20s, many times their first time seeing a doctor, with end-stage liver disease caused by alcohol,” he says. “This is a process of liver damage that we typically assume should take decades to happen.”

Tapper, with Michigan Medicine, describes the younger patients in his practice as “people who may have only started drinking recently” rather than those who have chronically overused alcohol. Drinking patterns, beverage choices and the “risk for getting injured from a given drink (have) all become worse,” he says.

“What is particularly tragic about deaths due to liver disease in young people is that these are people who do not have other major comorbidities. These are people who were going to go on and raise families and be productive members of the society, do important things across all strata of our society,” Tapper says. “That’s what makes dying in your 20s much more of an urgent public health problem.”

Dr. Jessica Mellinger, a specialist in hepatology, gastroenterology and internal medicine with Michigan Medicine, says alcohol-related liver disease accounts for at least half of the patients she sees, with a particularly notable increase among young women around the age of 30 who have cirrhosis or advanced liver disease.

Mellinger says she thinks such conditions may be developing faster in people who started using alcohol very young and then progressed rapidly to heavy drinking. She says contributing factors – such as binge drinking, obesity, depression or anxiety – may compound on top of each other, increasing a person’s risk. “We do seem to see alcohol use disorder coming in a package of a lot of other psychosocial issues that can make it more complex,” Mellinger says.

The rate of binge drinking in the U.S. – typically defined as four or more drinks for a woman or five or more drinks for a man within a couple hours or on one occasion – hovered around 17 percent between 2011 and 2017. Recent research also shows the annual number of drinks per adult who reported binge drinking has increased by 12 percent since 2011.

How the increase in harmful drinking patterns translates to health outcomes is still not well understood, Lee says. Yet Dr. Gabriel Schnickel, a liver, kidney and pancreas transplant surgeon with UC San Diego Health, notes that “not everyone processes alcohol the same.”

“You see a lot of people, these younger folks who ... think they’re drinking the same amount as their friends or same amount as people that they socialize with, but for them, it is doing irreversible damage to their liver,” Schnickel says. “We see a lot of young people come in who are in the throes of alcoholic hepatitis who had no idea that they could end up in that situation and, certainly, the terror in their eyes when they hear that they may need a new liver.”

Dr. Richard Saitz, chair of community health sciences at the Boston University School of Public Health, says factors beyond consumption, such as genetics and socioeconomics, may heighten a person’s risk.

“Some people can drink a lot and will never develop liver disease, just March 11, 2020• 17

While the prevalence of binge drinking in the U.S. is down, those who do it have raised more glasses overall.

like people can smoke a lot and not develop lung cancer,” Saitz says.

Culture plays a role, too, he says, with alcohol used in toasts “for just about anything” and larger serving sizes at bars and restaurants. Some cocktails and beers also have higher amounts of alcohol per drink than many may realize.

“People may think they’re having one drink, but they’re actually having two or two-and-a-half or three, just in one glass,” Saitz says. “Most people are not aware of what are considered risky amounts of alcohol or heavy amounts of alcohol, and when I talk to people about what they actually are – that is, scientifically what we know are the amounts that can increase health consequences pretty clearly – people are usually surprised.”

The trends point to the need to improve communication between physicians and patients about drinking habits before patients get to the stage of needing a new liver, says Aaron White, senior scientific advisor to the director of the National Institute on Alcohol Abuse and Alcoholism and an author of the NIAAA study.

Patricia Powell, NIAAA’s deputy director, adds that physicians are starting to recognize that “in order to treat a whole person, it’s really important to understand the level of alcohol consumption because it can affect so many things, even insidiously.”

“We are absolutely not neoprohibitionists – none of us think that alcohol should just disappear off the planet,” White says. Still, “it seems that something has shifted, where … the people who are binge drinking are blowing past that binge threshold” and heightening their risk of a host of health issues. Aside from liver disease, alcohol also is linked to certain types of cancer, for example.

With movements like Dry January and social events specifically without alcohol becoming more popular among millennials, White says some young and middle-aged adults are reevaluating their relationship with the substance from a healthy lifestyle perspective.

Seven months later, Garcia says he’s made several lifestyle changes – including cutting alcohol and most meat products from his diet. But he remains on the transplant waiting list.

“I came from a big drinking culture – a lot of my friends are the same way – so it’s not like it’s unprecedented or just like, ‘Oh my God, I woke up and this happened,’” Garcia says. “But there was no big red flashing warning sign that I (should’ve) stopped at all.”

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AUCTIONS AUCTION ALERT! 20+ Properties for Sale in RVA TAX SALE! Online and live auction for City of Richmond tax delinquent properties. Bidding begins Wednesday, March 25 at 2 p.m. Preview properties online today! Motleys, 3600 Deepwater Terminal Rd, Richmond, VA | www.motleys.com/rvataxsale | 877-MOTLEYS | VAL16

EAST COAST BOAT & RV AUCTION! Buy or sell – we are now accepting quality consignments for boats, RVS and powersports! Friday, April 3 at 12:30 pm. Bid live or online at richmondaa.com. Richmond Auto Auction | 804-232-7355 | 3600 Deepwater Terminal Road, Richmond, VA. VA16

ATTN. AUCTIONEERS: Advertise your upcoming auctions statewide or in other states. Affordable Print and Digital Solutions reaching your target audiences. Call this paper or Landon Clark at Virginia Press Services 804-521-7576, landonc@vpa.net

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Tuesday, March 31, 2020 2:00 p.m. ET – ITB 20-38/TM HVAC Upgrades to YH Thomas Community Center. Mandatory Pre-bid to be held on March 17, 2020 at 10:00 am et. Location: YH Thomas Gym, 1300 Thomas Street Hampton VA 23669.

For all forms or additional information, see our web page at https://www.hampton.gov/bids-contracts or call (757)727-2200. Minority-Owned, Woman-Owned and Veteran Businesses are encouraged to participate.